贲门失迟缓症Chapter 2 Achalasia of cardia
学习目标
1.了解POEM围手术期护理
2.掌握疾病指导与宣教
3.掌握以下词汇
achalasia 失迟缓症
dysphagia 吞咽困难
nausea 恶心
vomit 呕吐
malnutrition 营养不良
complication 并发症
esophagus 食管
countermeasure 干预措施
Liu Xiang is a patient in bed #5.He suffers from severe achalasia, with constant dysphagia, nausea and vomiting, chest pain, recurrent lung infections, and moderate malnutrition.He comes to the hospital for treatment.Lin Yun is his primary nurse.She is talking with Liu Xiang and giving him a health instruction.
Lin Yun: Good afternoon, Liu Xiang.Tomorrow you will undergo the peroral endoscopic myotomy (POEM).Do you know what to do before the operation?
Liu Xiang: Good afternoon, Lin Yun.This is my first hospitalization.I hope you can tell me what I am supposed to do.
Lin Yun: Sure.First, relax yourself and have trust in us.Second, fast for 12 hours before the procedure.Finally, do not eat or drink anything after the operation until your doctor allows you to.
Liu Xiang: OK, will I have any discomfort after the operation?
Lin Yun: There may be some complications.But don't worry,since we have countermeasures.For example, you might get an infection after the operation, and we will give you antibiotics when it occurs.
Liu Xiang: OK, thank you.What am I supposed to do afterwards?
Lin Yun: Certainly, you need to wear baggy clothes to avoid abdominal pressure increase.In addition, while sleeping, raise the head of the bed by 10-15 cm to help empty the esophagus.As for diet, eat small but frequent meals, and choose soft and calorie-rich foods with plenty ofnutrients.
Liu Xiang: OK, thank you very much.I will take your advice.
译文
刘翔是5床患者，他有非常严重的贲门失迟缓症，常有吞咽困难、恶心、呕吐、胸痛的感觉，有反复的肺部感染，伴有中度营养不良。他来医院接受治疗，林允是他的责任护士，她正在与刘翔对话，并对他进行健康宣教。
林允：中午好刘翔！明天你要做经内镜下环行肌切开手术（POEM），你知道手术前应该准备什么吗？
刘翔：中午好林允！这是我第一次住院，我不太懂，希望你能教我！
林允：好的。首先，你应该放松你的心情，不要太紧张，请相信我们的技术水平；其次，手术前大约12个小时你需要停止饮水，也就是说今晚8点以后你就不能饮水了；最后，手术结束后回到病房，你还是需要禁水，直到医生允许你饮水。
刘翔：好的，手术以后我会有不舒服症状吗？
林允：可能会有一些的，但是你不要紧张，我们有对症治疗措施！比如，术后可能会出现感染，我们会给你使用抗生素。
刘翔：好的，谢谢你们！那我以后需要注意什么吗？
林允：当然了，你以后要穿宽松的衣服，这样可以避免腹压增高；另外，睡觉的时候要把床头抬高10～15 cm，这样可以促进食管排空。在饮食方面，要注意饮食习惯，尽量少量多餐，选择柔软而富含热量的食物，补充充足的营养。
刘翔：好的，非常感谢你！我一定会听从你的意见！